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Updated: Jan 31, 2026

Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Progression of Ankle Plantarflexion Contractures and Functional Decline in Duchenne Muscular Dystrophy: Implications
Michael Kiefer1, Kelly Bonarrigo, Catherine Quatman-Yates
1Department of Pediatrics (Drs Kiefer and Wong), University of Massachusetts Medical School, Worcester, Massachusetts; Division of Occupational Therapy and Physical Therapy (Drs Kiefer, Bonarrigo, Quatman-Yates, and Fowler) and Division of Neurology (Drs Kiefer, Bonarrigo, Fowler, Horn, and Wong), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (Dr Horn), University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Physical Therapy (Dr Quatman-Yates), The Ohio State University, Columbus, Ohio.
Purpose:
This study characterizes the progressive loss of ankle dorsiflexion range of motion in boys with Duchenne muscular dystrophy (DMD), the relationship to functional decline, and the implications for physical therapy management.
Methods:
Longitudinal data for 332 boys with DMD were extracted from medical records and analyzed. Summary statistics for age, number of visits, ankle dorsiflexion measures, and North Star Ambulatory Assessment (NSAA) scores were computed.
Results:
Ankle dorsiflexion motion ranged from -32.5 to 25 degrees. Progression of ankle contractures is demonstrated by a trend line: slope -1.43 per year. NSAA score was estimated to decline approximately 0.23 points per 1 degree of ankle dorsiflexion lost.
Conclusions:
The results of this study describe the progression of ankle contractures and functional decline in DMD. The findings may help inform decisions regarding interventions to support participants with DMD and their families.
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